Active NPI
Leroy Johnson, PHARMACIST
- Pharmacist
- Lake Charles, LA
National Provider Identifier
1740595701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11421
- Practice address
- 4097 Ryan St
Lake Charles, LA 70605-2819 - Phone
- (337) 474-0434
- Fax
- (337) 474-2778
- NPI assigned
- Aug 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11421 | LA | Primary |
Addresses
Primary practice location
4097 Ryan St
Lake Charles, LA 70605-2819
Mailing address
4097 Ryan St
Lake Charles, LA 70605-2819
Phone (337) 474-0434
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11421 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281830400000",
"number": "1740595701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4097 RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052819",
"telephone_number": "337-474-0434",
"fax_number": "337-474-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4097 RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052819",
"telephone_number": "337-474-0434",
"fax_number": "337-474-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LEROY",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-15",
"last_updated": "2010-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.